May 2020

COVID-19 Response

COVID-19 Related News Page

For your convenience, we launched the COVID-19 Related News page. You’ll find all COVID-19 News and Updates on this page, which may be accessed from the News and Updates and COVID-19 Preparedness pages. As additional COVID-19 items are added, we’ll update the COVID-19 Related News page.

CMO Perspective

Health Equity: Before, During and After COVID-19

In this month’s CMO Perspective, our Vice President and Chief Medical Officer, Dr. Derek J. Robinson, M.D., MBA, FACEP, CHCQM, discusses racial disparities in COVID-19 infection and death rates. As Dr. Robinson notes, “When we think back to what we considered to be normal life before COVID-19, we realize that many of the same communities across Illinois that are experiencing higher COVID-19 transmission rates have also experienced shorter life expectancies, disproportionately high rates of infant mortality and concentrated poverty.”

Electronic Options

Alert: iExchange^® Deactivation Extended Due to COVID-19

In response to COVID-19, the iExchange deactivation planned for April 15, 2020, has been temporarily suspended to offer you an extension to convert to the Availity^® Authorizations tool during this pandemic.

Get Claim Status Results in Real-time on the Availity Provider Portal

Using the online options on the Availity Provider Portal provides a convenient, efficient and secure method of requesting detailed claim status from Blue Cross and Blue Shield of Illinois (BCBSIL). There are two Availity Claim Status offerings: one for commercial claims, and one for government programs claims.

Clinical Updates, Reminders and Related Resources

Attention High-Tech Imaging Providers: Complete Your OptiNet^® Assessment

OptiNet is an online assessment tool developed by AIM Specialty Health^® (AIM) to collect modality-specific data from imaging providers. If you bill BCBSIL for the technical component of CT/CTA, MRI/MRA, Nuclear Cardiology or PET scans, you must complete an OptiNet assessment – otherwise your facility will not appear in AIM’s online directory. This directory is used by ordering providers during the Radiology Quality Initiative (RQI) process, which AIM administers for BCBSIL.

Wellness and Member Education

New Annual Wellness Visit Resources for Medicare Providers

We have two new resources to help you care for our Medicare Advantage members during their annual wellness visits.

Claims and Coding

Important Reminder Regarding Billing for Point-of-Use Convenience Kits

BCBSIL regularly reviews claims submitted by providers to help ensure that benefits provided are for services that are included in our member’s benefit plan and meet BCBSIL’s guidelines.

Attention Non-emergent Transportation Providers: Medicaid Claim Process Changes, Updated March 27, 2020

As we announced in last month’s Blue Review, BCBSIL is making some claims servicing changes for non-emergent transportation services provided to our Blue Cross Community Health Plans^SM (BCCHP^SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)^SM members. This is a follow-up article to remind you of additional changes made after publication of the original notice.

Pharmacy Program

Pharmacy Program Updates: Quarterly Pharmacy Changes Effective on or after July 1, 2020 – Part 1

Based on the availability of new prescription medications and Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some additions, revisions (drugs still covered but moved to a higher out-of-pocket payment level) and/or exclusions (drugs no longer covered) were made to the BCBSIL drug lists. Changes effective on or after July 1, 2020, are outlined here.

Provider Education

Commercial PPO and BCCHP Providers: Join Us for An Orientation Webinar

Our Provider Relations team is pleased to announce quarterly orientations for providers who are contracted with BCBSIL’s commercial PPO, Blue Choice PPO^SM and/or BCCHP networks.

Provider Learning Opportunities

BCBSIL offers free webinars and workshops for the independently contracted providers who work with us. A preview of upcoming training sessions is included in this month’s issue.

Notification and Disclosure

Important Dates and Reminders

Check here each month for a quick snapshot of recent implementations, upcoming changes, special events, important deadlines and other reminders.

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